The clinical case study manuscript and virtual grand round presentation require students to individually complete and professionally present a clinical nutrition case study on the nutrition management of a patient with a complex acute or chronic disease/condition. The manuscript and presentation must highlight the pathophysiology of the disease/condition, describe findings from a comprehensive nutrition-focused physical exam (NFPE) and nutrition assessment, use the Nutrition Care Process (NCP) to organize and present patient data and prescribe a clinical nutrition intervention, monitoring, and evaluation plan based on a focused review of current and best available scholarly evidence. The content and approach of the manuscript and presentation must be applicable to an audience of healthcare professionals from a variety of disciplines (i.e., medicine, dentistry, nursing, pharmacy, social work, therapy, etc.).
Students must identify a real-world or fictitious patient case. The case must be for an adult patient (age 18+ years old) and demonstrate nutrition management of a patient with a complex medical condition (beyond entry-level). The case should include opportunity for focused nutrition intervention so that in-depth review of the current scholarly literature can be conducted and evidence-informed findings can be applied to nutrition management of the patient.
The Doctor of Clinical Nutrition Program follows the UNE grading system for all courses, as outlined below. Matriculated graduate students must maintain a cumulative GPA of 3.0 (B) or better. Failure to do so will result in academic probation and possible termination from the program. Any student receiving a grade below B- on any individual course has failed that course and must re-enroll and repeat the course to achieve a grade of B- or better. Any student who receives a grade of F in two or more courses is dismissed from the program. Please note: A minimum of a 3.0 GPA is required for degree conferral.
Schedule
Course weeks run from 12:00 AM ET on Wednesday through 11:59 PM ET on Tuesday, with the exception of Week 16, which ends on Sunday at 11:59 PM ET. Unless otherwise specified, all discussion comments and assignments are due on the last day of the course week in which they are assigned. Unless otherwise noted, initial responses to discussion prompts are due by the end of Sunday, and peer responses are due by the end of Tuesday.
ALL TIMES ARE IN THE EASTERN STANDARD TIME ZONE, NO EXCEPTIONS.
Course Dates
Week 1: Sep 4 – Sep 10
Week 2: Sep 11 – Sep 17
Week 3: Sep 18 – Sep 24
Week 4: Sep 25 – Oct 1
Week 5: Oct 2 – Oct 8
Week 6: Oct 9 – Oct 15
Week 7: Oct 16 – Oct 22
Week 8: Oct 23 – Oct 29
Week 9: Oct 30 – Nov 5
Week 10: Nov 6 – Nov 12
Week 11: Nov 13 – Nov 19
Week 12: Nov 20 – Nov 26
Week 13: Nov 27 – Dec 3
Week 14: Dec 4 – Dec 10
Week 15: Dec 11 – Dec 17
Week 16: Dec 18 – Dec 22
Please note: Weeks 1 and 16 will only open on their designated start date after course surveys have been completed.
Week 1: Nutrition Care Process and Clinical Reasoning
Learning Outcomes
Students will be able to:
- Apply clinical reasoning skills and current scientific evidence in the provision of nutrition care.
- Utilize the eNCPT to document and implement nutrition care that demonstrates alignment among each step of the Nutrition Care Process.
- Justify nutrition care decisions within the framework of the Nutrition Care Process and current scientific evidence.
Lectures and Multimedia
- Nutrition Care Process Tutorial
- NCP Step 1: Nutrition Assessment
- NCP Step 2: Nutrition Diagnosis
- NCP Step 3: Nutrition Intervention
- NCP Step 4: Nutrition Monitoring and Evaluation
Required Readings
- Hakel-Smith N, Lewis NM. A standardized nutrition care process and language are essential components of a conceptual model to guide and document nutrition care and patient outcomes. J Am Diet Assoc. 2004;104:1878-1884.
- Murphy WJ, Yadrick MM, Steiber AL, Mohan V, Papoutsakis C. Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII): a pilot study on the documentation of the Nutrition Care Process and the usability of ANDHII by registered dietitian nutritionists. J Acad Nutr Diet. 2018;118(10):1966-1974.
- Lewis SL, Wright L, Arikawa AY, Papoutsakis C. Etiology intervention link predicts resolution of nutrition diagnosis: a Nutrition Care Process outcomes study from a veterans’ health care facility. J Acad Nutr Diet. 2021;121(9):1831-1840.
- Colin C, Arikawa A, Lewis S, et al. Documentation of the evidence-diagnosis link predicts nutrition diagnosis resolution in the Academy of Nutrition and Dietetics’ diabetes mellitus registry study: A secondary analysis of Nutrition Care Process outcomes. Front Nutr. 2023;10:1011958. doi:10.3389/fnut.2023.1011958
- The Concept of Clinical Utility for Diagnostic Tests
- Lesko LJ, Zineh I, Huang SM. What is clinical utility and why should we care? Clin Pharmacol Ther. 2010;88(6):729-733.
- Public Health Impact of Digital Health: Reinventing the Wheel
See course for supplemental reading.
Assignments
- Student Syllabus Contract – Must be completed prior to accessing the materials in Week 1
- DCN Orientation Quiz
- Week 1 Assignment: Nutrition Care Process Case Study and Audit
Discussions
- Student Introductions Discussion
Week 2: Malnutrition and Nutrition-Focused Physical Examination
Learning Outcomes
Students will be able to:
- Analyze the impact of malnutrition on the healthcare system.
- Distinguish similarities and differences in causes, physiologic characteristics, and diagnostic criteria among malnutrition, sarcopenia, and cachexia.
- Appraise the validity and clinical utility of existing malnutrition criteria and assessment tools based on patient population.
- Evaluate the role of nutrition-focused physical exam (NFPE) in identifying malnutrition, sarcopenia, and cachexia.
- Implement existing criteria and assessment tools to identify malnutrition in adult and pediatric patients.
Lectures and Multimedia
- Malnutrition Matters for Adult Patients
- Malnutrition Matters for Pediatric Patients
- GLIM Educational Series Part 1: What is GLIM?
- GLIM Educational Series Part 2: Conducting Studies to Validate the GLIM Criteria
- Nutrition Focused Physical Assessment Part 1: Setting the Stage for Success
Required Readings
- Academy/ASPEN Adult Malnutrition Assessment Characteristics: White J, Guenter P, Jensen G, Malone A, Schofield M. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition. J Acad Nutr Diet. 2012;112:730-738.
- Academy/ASPEN Pediatric Malnutrition Assessment Characteristics: Becker PJ, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). J Acad Nutr Diet. 2014;114:1988-2000.
- Global Leadership Initiative on Malnutrition (GLIM): Cederholm T et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9.
- Secker DJ, Jeejeebhoy KN. How to perform subjective global nutritional assessment in children. J Acad Nutr Diet. 2012;112(3):424-431.e6. doi: 10.1016/j.jada.2011.08.039
- Hummel AC, Cummings M. Role of the nutrition-focused physical examination in identifying malnutrition and its effectiveness. Nutr Clin Pract. 2022;37(1):41-49.
- Corkins KG. Nutrition-focused physical examination in pediatric patients. Nutr Clin Pract. 2015;30(2):203-209.
- Chapter 4: Physical Examination. In: Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates’ Guide to Physical Examination and History Taking. 13th ed. Wolters Kluwer; 2021:113-134.
See course for supplemental reading.
Assignments
- Week 2 Assignment: Malnutrition Assessment Case Study
Discussions
- Week 2 Discussion: Clinical Controversy – Validated Identification of Malnutrition
Week 3: Dietary Assessment and Estimating Energy Requirements
Learning Outcomes
Students will be able to:
- Assess dietary intake in clinical practice and nutrition research using valid and reliable methods.
- Appraise the validity and clinical utility of current predictive energy equations as applied to specific patient populations.
- Select and implement valid and reliable methods to measure and predict energy expenditure based on patient demographics and clinical status.
- Integrate knowledge of anatomy, physiology, and biochemistry when assessing and interpreting estimated energy requirements.
- Analyze the effects of disease, clinical condition, and treatment on nutritional health status, specifically related to energy metabolism and estimated energy requirements.
Lectures and Multimedia
- Physiology and Fundamentals of Indirect Calorimetry
- Indirect Calorimetry – A Closer Look | GE Healthcare
- KORR Webinar: Indirect Calorimetry and Energy Expenditure: Guess or Measure?
Required Readings
- Walton J. Dietary assessment methodology for nutritional assessment: A practical approach. Top Clin Nutr. 2015;30(1):33-46.
- McClung HL, Ptomey LT, Shook RP. Dietary intake and physical activity assessment: current tools, techniques, and technologies for use in adult populations. Am J Prev Med. 2018;55(4):e93-e104.
- Hills AP, Mokhtar N, Byrne NM. Assessment of physical activity and energy expenditure: an overview of objective measures. Front Nutr. Published online June 16, 2014. doi: 10.3389/fnut.2014.00005.
- Frankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc. 2005;105:775-789.
- Bendavid I, Lobo DN, Barazzoni R, et al. The centenary of the Harris-Benedict equations: How to assess energy requirements best? Recommendations from the ESPEN expert group. Clin Nutr. 2021;40(3):690-701.
- Fullmer S, Benson-Davies S, Earthman CP, et al. Evidence analysis library review of best practices for performing indirect calorimetry in healthy and non-critically ill individuals. J Acad Nutr Diet. 2015;115:1417-1446.
- Schlein KM, Coulter SP. Best practices for determining resting energy expenditure in critically ill adults. Nutr Clin Pract. 2014;29(1):44-55.
- Hipskind P, Glass C, Charlton D, Nowak D, Dasarathy S. Do hand-held calorimeters have a role in assessment of nutrition needs in hospitalized patients? A systematic review of literature. Nutr Clin Pract. 2011;26(4):426-433.
See course for supplemental reading.
Assignments
- Week 3 Assignment Part 1: Key Assessment Case Study Topic and Draft IRB Application
- Week 3 Assignment Part 2: Key Assessment IRB Application Submission
Discussions
- Week 3 Discussion: Clinical Controversy – Predicting Energy Expenditure
Week 4: Anthropometrics and Body Composition
Learning Outcomes
Students will be able to:
- Recognize methods, tools, and techniques to assess anthropometrics and body composition in clinical nutrition practice and nutrition research.
- Select valid and reliable tools in the assessment of anthropometrics and body composition based on patient demographics and clinical status.
- Perform accurate measurement and interpretation of anthropometrics and body composition in the assessment of nutrition status.
- Integrate knowledge of anatomy and physiology when assessing or examining anthropometrics and body composition.
- Analyze the effects of disease, clinical condition, and treatment on nutritional health status, specifically as they relate to findings from nutrition-focused physical examination and assessment of anthropometrics and body composition.
- Conduct a nutrition-focused physical exam to differentiate and interpret normal versus abnormal findings related to muscle, fat, and fluid.
Lectures and Multimedia
- Nutrition Focused Physical Assessment Part 2: Creating Your Malnutrition Toolbox
- Principles of NFPE
- Demonstration of Head-to-Toe NFPE
- Anthropometric Procedures – Height (3 of 8)
- Focus On Undernutrition – Ulna Height Measurement
- Determine Mid Upper Arm Circumference
- Anthropometric Procedures – Circumference (5 of 8)
- Measuring Waist Circumference
- What’s the Difference Between an MRI and a CT?
- DEXA Scan Facts
- Bioelectrical Impedeance Analysis
- Bod Pod: Measuring Body Composition (Body Fat) at the Exercise Physiology Core Laboratory
- mBCA 514/ 515 | Process and measurement protocols
- mBCA 514/ 515 | Performing a measurement
- Body composition analysis in clinical application
Required Readings
- Madden AM, Smith S. Body composition and morphological assessment of nutritional status in adults: a review of anthropometric variables. J Hum Nutr Diet. 2016;29(1):7-25. doi: 10.111/jhn.12278
- Corkins KG, Teague EE. Pediatric nutrition assessment: anthropometrics to zinc. Nutr Clin Pract. 2018;32(1):40-51.
- Andreoli A, Garaci F, Pio Cafarelli FP, Guglielmi G. Body composition in clinical practice. Eur J Radiol. 2016;85(8):1461-1468. Doi: 10.1016/j.ejrad.2016.02.005
- Hummel AC, Cummings M. Role of the nutrition-focused physical examination in identifying malnutrition and its effectiveness. Nutr Clin Pract. 2022;37(1):41-49.
- Fischer M, JeVenn A, Hipskind P. Evaluation of muscle and fat loss as diagnostic criteria for malnutrition. Nutr Clin Pract. 2015;30(2):239-248.
- Barazzoni R, Jensen GL, Correia MITD, et al. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr. 2022;41(6):1425-1433.
- Ratliff A. Assessment of fluid accumulation. Support Line. 2015;37(5):5-7, 9-10.
See course for supplemental reading.
Assignments
- Week 4 Assignment: Practicing NFPE to Assess Muscle, Fat, and Fluid
Discussions
- Week 4 Discussion: Clinical Controversy – Body Measurements and Qualification of Malnutrition and Cardiometabolic Risk
Week 5: Functional Status, Physical Activity, and Integumentary System
Learning Outcomes
Students will be able to:
- Recognize methods, tools, and techniques to examine or assess functional status, physical activity, and the integumentary system as part of NFPE and nutrition assessment.
- Integrate knowledge of anatomy and physiology when examining or assessing functional status, physical activity, and the integumentary system.
- Analyze the effects of disease, clinical condition, and treatment on nutritional health status, specifically related to NFPE findings and assessments of functional status, physical activity, and the integumentary system.
- Conduct a NFPE to differentiate and interpret normal versus abnormal findings related to functional status and the integumentary system.
- Create a plan of action (standard operating procedure) to measure, assess, and interpret anthropometrics, body composition, and functional status in a specific patient population and practice setting.
Lectures and Multimedia
- Nutrition & Pressure Injuries: Putting the New Guidelines into Practice
- Hand Grip Dynamometry (by T. Scollard, Dietitians in Nutrition Support)
- 4-Meter Walk Gait Speed
- 30-second Chair Stand Test (by CDC)
- 4-Stage Balance Test
- Timed-Get-Up-and-Go Test (by CDC)
- Skin Color Alterations & Edema
- Primary & Secondary Lesions
- Nail Assessment
Required Readings
- Beaudart C, Rolland Y, Cruz-Jentoft AJ, et al. Assessment of muscle function and physical performance in daily clinical practice: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif Tissue Int. 2019;105(1):1-14.
- Lee SH, Gong HS. Measurement and interpretation of handgrip strength for research on sarcopenia and osteoporosis. J Bone Metab. 2020;27(2):85-96.
- Whitsel LP, Bantham A, Jarrin R, Sanders L, Stoutenberg M. Physical activity assessment, prescription and referral in US healthcare: How do we make this a standard of clinical practice? Prog Cardiovasc Dis. 2021;64:88-95.
- Chapter 10: Skin, Hair, and Nails. In: Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates’ Guide to Physical Examination and History Taking. 13th ed. Wolters Kluwer; 2021:282-334.
- DiBaise M, Tarleton SM. Hair, nails, and skin: Differentiating cutaneous manifestations of micronutrient deficiency. Nutr Clin Pract. 2019;34(4):490-503.
- White M, Huynh BB, Hua AB, Strickland R, Johnson CD, Warner BF. What fingernails say about oral-systemic health. RDH Magazine. Published online Dec 12, 2022.
- Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016;43(6):585-597.
- Munoz N, Litchford M, Cox, J, Nelson JL, Nie AM, Delmore B. Malnutrition and pressure injury risk in vulnerable populations: Application of the 2019 International Clinical Practice Guideline. Adv Skin Wound Care. 2022;35:156-165.
- Munoz N, Posthauer ME, Cereda E, Schols JMGA, Haesler E. The role of nutrition for pressure injury prevention and healing: The 2019 International Clinical Practice Guidelines Recommendations. Adv Skin Wound Care. 2020;33:123-136.
See course for supplemental reading.
Assignments
- Week 5 Assignment: Anthropometric, Body Composition, and Functional Status Standard Operating Procedure
Discussions
- No discussion assignment this week
Week 6: Head, Neck, and Oral Cavity
Learning Outcomes
Students will be able to:
- Evaluate and define the role of the RDN in screening for dysphagia.
- Integrate knowledge of anatomy and physiology when conducting head, neck, and oral examinations and assessments.
- Analyze the effects of disease, clinical condition, and treatment on nutritional health status, specifically related to findings from NFPE and assessment of the head, neck, and oral cavity.
- Conduct an NFPE to differentiate and interpret normal versus abnormal presentation of mucous membranes, neurological function, and muscle function associated with the oral, facial, and esophageal regions of the body.
Lectures and Multimedia
- Sugar, Nutrition and Oral Health (5th Annual UCSF Global Oral Health Symposium)
Required Readings
- Chapter 11: Head and Neck. In: Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates’ Guide to Physical Examination and History Taking. 13th ed. Wolters Kluwer; 2021:335-354.
- Chapter 24: Nervous System. In: Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates’ Guide to Physical Examination and History Taking. 13th ed. Wolters Kluwer; 2021:841-934. – Read the section on Techniques of Examination of the Cranial Nerves.
- Chapter 14: Throat and Oral Cavity. In: Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates’ Guide to Physical Examination and History Taking. 13th ed. Wolters Kluwer; 2021:419-440.
- Radler DR, Lister T. Nutrient deficiencies associated with nutrition-focused physical findings of the oral cavity. Nutr Clin Pract. 2013;28(6):710-721. doi: 10.1177/0884533613507284
- Matheson EM, Fermo JD, Blackwelder RS. Temporomandibular disorders: rapid evidence review. Am Fam Physician. 2023;107(1):52-58.
- McGinnis CM, Homan K, Solomon M, et al. Dysphagia: interprofessional management, impact, and patient-centered care. Nutr Clin Pract. 2019;34(1):80-95.
See course for supplemental reading.
Assignments
- Week 6 Assignment: Practicing NFPE to Assess Head, Neck, Face, and Oral Cavity
Discussions
- Week 6 Discussion: Clinical Controversy – Role of the RDN in Dysphagia Screening
Week 7: Vital Signs and Biochemical Indices
Learning Outcomes
Students will be able to:
- Evaluate the evidence for use and interpretation of biochemical indices in nutrition assessment, nutrition diagnosis, and nutrition monitoring and evaluation.
- Select valid and reliable vital signs and biochemical indices in the assessment of patient nutrition status.
- Perform assessment of vital signs.
- Evaluate accuracy, reliability, and currency of vital signs and biochemical indices to make best decisions related to nutrition care.
- Interpret findings from vital signs and biochemical indices within the context of human physiology, biochemistry, disease status, clinical condition, and treatment.
Lectures and Multimedia
- Nutrition Focused Physical Assessment Part 3: Micronutrient Deficiencies
- Measurement and Interpretation of Vital Signs – Part 1
- Measurement and Interpretation of Vital Signs – Part 2
- Biochemical Indices
- Accurate Measurement of Blood Pressure
- Pediatric Measurement of Blood Pressure
Required Readings
- Chapter 8: General Survey, Vital Signs, and Pain. In: Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates’ Guide to Physical Examination and History Taking. 13th ed. Wolters Kluwer; 2021:211-240.
- Bossuyt PMM, Reitsma JB, Linnet K, Moons KGM. Beyond diagnostic accuracy: the clinical utility of diagnostic tests. Clinical Chemistry. 2012;58(12):1636-1643.
- Evans DC, Corkins MR, Malone A, et al. The use of visceral proteins as nutrition markers: An ASPEN position paper. Nutr Clin Pract. 2021;36(1):22-28.
- Berger MM, Talwar D, Shenkin A. Pitfalls in the interpretation of blood tests used to assess and monitor micronutrient nutrition status. Nutr Clin Pract. 2023;38:56-69.
- Keller U. Nutritional laboratory markers in malnutrition. J Clin Med. 2019;8(6):775. doi: 10.3390/jcm8060775
See course for supplemental reading.
Assignments
- Week 7 Assignment: Vital Sign and Biochemical Case Study
Discussions
- Week 7 Discussion: Clinical Controversy – Biochemical Validity and Utility
Week 8: Malnutrition Screening
Learning Outcomes
Students will be able to:
- Appraise the validity and clinical utility of existing malnutrition screening criteria and tools based on patient population.
- Select appropriate malnutrition screening and identification tools based on validation criteria.
- Perform nutrition screening and assessment using validated tools to identify risk factors and presence of malnutrition in patient populations across the life cycle.
- Interpret and analyze the effects of disease, clinical condition, and treatment on nutrition health status, particularly as they relate to malnutrition.
- Formulate nutrition interventions to resolve the nutrition diagnosis or related nutrition clinical indicators based on best-available scholarly evidence and patient-centered goals.
- Align each component of the Nutrition Care Process to support, monitor, and evaluate nutrition outcomes.
Lectures and Multimedia
- Malnutrition Screening – Part 1
- Malnutrition Screening – Part 2
- Eicosanoids: Formation, Function, and Subclasses
Required Readings
- Correia MITD. Nutrition screening vs nutrition assessment: what’s the difference? Nutr Clin Pract. 2018;33(1):62-78.
- Skipper A, Coltman A, Tomesko J, et al. Position of the Academy of Nutrition and Dietetics: malnutrition (undernutrition) screening tools for all adults. J Acad Nutr Diet. 2020;120(4):709-713.
- House M, Gwaltney C. Malnutrition screening and diagnosis tools: implications for practice. Nutr Clin Pract; 2022;37(1):12-22.
- Review the AND EAL for Nutrition Screening Adults
- Specifically, read the main page (key findings) and the tool components & descriptions.
- Review the AND EAL for Nutrition Screening Pediatrics –
- Specifically, read the main page (key findings) and the tool components & descriptions.
- Becker PJ, Brunet-Wood MK. Pediatric malnutrition screening and assessment tools: analyzing the gaps. Nutr Clin Pract. 2022;37(5):1088-1104.
- Shepherd E. Malnutrition coding and reimbursement in the hospital setting. Nutr Clin Pract. 2022;37(1):35-40.
See course for supplemental reading.
Assignments
- Week 8 Assignment Part 1: Comprehensive Malnutrition Case Study
- Week 8 Assignment Part 2: Comprehensive NFPE
Discussions
- Week 8 Discussion: Nutrition Assessment and NFPE Reflection
Week 9: MUFAs and PUFAs – The Omega 3, 6, and 9s
Learning Outcomes
Students will be able to:
- Analyze current scientific research to identify the strengths, limitations, and application of omega-3, 6, and 9 fatty acids as a therapeutic intervention for the prevention or management of diverse disease states and clinical conditions.
- Align current scientific research regarding assessment, prescribing, monitoring, and evaluating the therapeutic use of omega-3, 6, and 9 fatty acids with the steps of the Nutrition Care Process.
- Generate evidence-based recommendations for translating current findings from omega-3, 6, and 9 fatty acid research into nutrition practice.
Lectures and Multimedia
- Eicosanoids: Formation, Function, and Subclasses
Required Readings
- Cholewski M, Tomczykowa M, Tomczyk M. A comprehensive review of chemistry, sources and bioavailability of omega-3 fatty acids. Nutrients. Published online November 4, 2018;10(11):1662. doi: 10.3390/nu10111662
- Kim HK, Kang EY, Go GW. Recent insights into dietary w-6 fatty acid health implications using a systematic review. Food Sci Biotechnol 2022;31(11):1365-1376.
- Saini RK, Keum YS. Omega-3 and omega-6 polyunsaturated fatty acids: dietary sources, metabolism, and significance – a review. Life Sci. 2018;203:255-267.
- Farag MA, Gad MZ. Omega-9 fatty acids: potential roles in inflammation and cancer management. J Genet Eng Biotechnol.
See course for supplemental reading.
Assignments
- Week 9 Assignment: Key Assessment – Clinical Nutrition Case Study Manuscript Draft
Discussions
- Week 9 Discussion: Clinical Controversy – MUFAs and PUFAs in Nutrition Practice
Week 10: Plant-Based Diets
Learning Outcomes
Students will be able to:
- Compare definitions and principles of plant-based diets across diverse application settings including research, healthcare practice, and consumer adoption.
- Analyze the impact of plant-based diets on physiological processes and nutrition status.
- Evaluate the efficacy and effectiveness of plant-based diets when prescribed for tertiary prevention of specific disease states and clinical conditions.
- Generate evidence-based recommendations for translating current findings regarding the efficacy and effectiveness of a plant-based diet for tertiary prevention to nutrition practice.
Lectures and Multimedia
- Introduction to Plant-Based Diets
- Podcast: Plant-Based Protein Diets
Required Readings
- Craig WJ, Mangels AR, Fresan U, et al. The safe and effective use of plant-based diets with guidelines for health professionals. Nutrients. 2021;13(11):4144.
- Kent G, Kehoe L, Flynn A, Walton J. Plant-based diets: a review of the definitions and nutritional role in the adult diet. Proc Nutr Soc. 2022;81(1):62-74.
- Hertzler SR, Lieblein-Boff JC, Wieler M, Allgeier C. Plant proteins: assessing their nutritional quality and effects on health and physical function. Nutrients. Published online November 30, 2020;12(12):3704.
- Koeder C, Perez-Cueto FJA. Vegan nutrition: a preliminary guide for health professionals. Crit Rev Food Sci Nutr. 2024;64(3):670-707.
- AND EAL Vegetarian Nutrition
See course for supplemental reading.
Assignments
- Week 10 Assignment: Key Assessment Instructor-Student Conference
Discussions
- Week 10 Discussion: Clinical Controversy – Are Plant-Based Diets Clinically, Nutritionally, and Ethically Appropriate?
Week 11: Vitamin D
Learning Outcomes
Students will be able to:
- Analyze current scientific research to identify strengths, limitations, and application of vitamin D as a therapeutic intervention for prevention or management of diverse disease states and clinical conditions.
- Align current scientific research regarding assessment, prescribing, and monitoring and evaluating the therapeutic use of vitamin D with the steps of the Nutrition Care Process.
- Generate evidence-based recommendations for translating current findings from vitamin D research to nutrition practice.
Lectures and Multimedia
- Vitamin D: Dietary Sources, Metabolism, and Health Considerations
Required Readings
- Alonso N, Zelzer S, Eibinger G, Herrmann M. Vitamin D metabolites: analytical challenges and clinical relevance. Calcif Tissue Int. 2023;112(2):158-177.
- Dnoati S, Palmini G, Aurilia C, et al. Calcifediol: mechanisms of action. Nutrients. Published online October 17, 2023;15(20):4409. doi: 10.3390/nu15204409
- Giustina A, Adler RA, Binkley N, et al. Consensus statement from 2nd International Conference on Controversies in Vitamin D. Rev Endocr Metab Disord. 2020;21(1):89-116.
- Myers EF. Considerations identified from the dialogue focused on evidence-based decision-making and vitamin D: implications for the Nutrition Care Process. J Acad Nutr Diet. 2019;119(6):910-914.
- Taylor CL, Rosen CJ, Dwyer JT. Considerations in dietetic counseling for vitamin D. J Acad Nutr Diet. 2019;119(6):901-905.
- Bleizgys A. Vitamin D dosing: basic principles and a brief algorithm. Nutrients. Published online December 10, 2021;13(12):4415. doi: 10.3390/nu13124415
See course for supplemental reading.
Assignments
Discussions
- Week 11 Discussion: Clinical Controversy – Vitamin D…Therapeutic Benefit or Bunk?
Week 12: Nutrition Support
Learning Outcomes
Students will be able to:
- Synthesize findings from nutrition assessment to guide nutrition diagnosis and decision-making related to recommendations for nutrition support interventions.
- Formulate nutrition support interventions appropriate to the medical and nutritional needs of the patient.
- Develop a plan to monitor and evaluate patient tolerance to nutrition support.
- Justify nutrition support decisions and management plans using evidence-based guidelines and current scholarly literature.
Lectures and Multimedia
- Metabolics Monitoring: Indirect Calorimetry
- Formulary Updates: Evaluating New Lipids for Your Institution
- The Impact of IV Lipids on Infection Risk
- Choosing Wisely: Feeding Tube Selection Basics and Complication Prevention Strategies
- A Look at ASPEN’s Clinical Recommendations for Blenderized Tube Feeding
- Blenderized Tube Feeding: Introduction
- Basics of Homemade Blenderized Tube Feeding Preparation
Required Readings
- Lesser MNR, Lesser LI. Nutrition support therapy. Am Fam Physician. 2021;104(6):580-588.
- Reddick CA, Greaves JR, Flaherty JE, Callihan LE, Larimer CH, Allen SA. Choosing wisely: enteral feeding tube selection, placement, and considerations before and beyond the procedure room. Nutr Clin Pract. 2023;38:216-239.
- Yeganehjoo M, Johanek J. Role of registered dietitians in nasoenteric feeding tube placement. Nutr Clin Pract. 2023;38:1225-1234.
- Church A, Zoeller S. Enteral nutrition product formulations: a review of available products and indications for use. Nutr Clin Pract. 2023;38:277-300.
- Epp L, Blackmer A, Church A, et al. Blenderized tube feedings: practice recommendations from the American Society for Parenteral and Enteral Nutrition. Nutr Clin Pract. 2023;38:1190-1219.
See course for supplemental reading.
Assignments
- Week 12 Assignment: Nutrition Support Case Study
Discussions
- Week 12 Discussion: Clinical Controversy – Trends and Practices in Nutrition Support
Week 13: ERAS and Immunonutrition
Learning Outcomes
Students will be able to:
- Examine utilization of enhanced recovery after surgery (ERAS) guidelines and immunonutrition across diverse patient populations and practice settings.
- Evaluate outcomes resulting from implementation of ERAS guidelines and prescription of immunonutrition.
- Propose opportunities for RDN involvement in ERAS guideline implementation and provision.
Lectures and Multimedia
- Implementation of an Enhanced Recovery Program (by ASPEN)
- The Role of Nutrition in ERAS Surgery (by ERAS Society)
- No More Overnight Fasting ERAS (by ERAS Society)
- Promoting Early Feeding and Early Mobilization ERAS (by ERAS Society)
Required Readings
- Altman AD, Helpman L, McGee J, et al. Enhanced recovery after surgery: implementing a new standard of surgical care. CMAJ. 2019;191(17):E469-E475.
- AANA Clinical Practice Resources – Enhanced Recovery After Surgery
- Martinez-Ortega AJ, Pinar-Gutierrez A, Serrano-Aguayo P, et al. Perioperative nutritional support: a review of current literature. Nutrients. Published online April 22, 2022;14(8):1601. doi: 10.3390/nu14081601
- Gould H. Immunonutrition in the acute care setting. Support Line. 2023;45(6):2-12.
See course for supplemental reading.
Assignments
- Week 13 Assignment: ERAS Case Study
Discussions
- Week 13 Discussion: ERAS and the RDN
Week 14: Chronic Metabolic Dysfunction and Disease
Learning Outcomes
Students will be able to:
- Implement the Nutrition Care Process to nutritionally assess, diagnose, intervene, and monitor/evaluate outcomes on a patient with complex metabolic dysfunction.
- Evaluate the impact of current research and emerging trends in the treatment of metabolic diseases on patient nutrition status, nutrition interventions, and the roles and responsibilities of the RDN as a member of the interprofessional healthcare team.
- Advocate for professional change and innovation in the field of nutrition and dietetics when providing care to patients with complex metabolic dysfunction and disease.
Lectures and Multimedia
- The IH Perspective: ASMBA/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2022 (By ASMBS)
- 2023 Webinar: Embracing Change: A Shift in Steatotic Liver Disease Nomenclature from NAFLD to MASLD (By AASLD)
- Strategies for Managing Obesity to Reduce Cardiovascular Risks with Weight Loss Pharmacotherapy (by PeerView CME)
Required Readings
- Perdomo CM, Cohen RV, Sumithran P, Clement K, Fruhbeck G. Contemporary medical, device, and surgical therapies for obesity in adults. Lancet. 2023;401(10382):1116-1130.
- Boer GA, Hay DL, Tups A. Obesity pharmacotherapy: incretin action in the central nervous system. Trends Pharmacol Sci. 2023;44(1):50-63.
- Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis. 2022;18:1345-1356.
- Rinella ME, Lazarus JV, Ratzui V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023;78(6):1966-1986.
See course for supplemental reading.
Assignments
Discussions
- Week 14 Discussion: Clinical Controversy – Emerging Trends in Metabolic Disease Treatment and the Role of the RDN
Week 15: Case Study Presentations
Learning Outcomes
Students will be able to:
- Produce a case study manuscript following publication guidelines of a leading peer-reviewed scientific journal.
- Create a professional presentation on a topic of interprofessional interest for delivery at clinical grand round.
- Dialogue with peers on a clinical topic to support mutual professional growth and development.
Lectures and Multimedia
Required Readings
- Perdomo CM, Cohen RV, Sumithran P, Clement K, Fruhbeck G. Contemporary medical, device, and surgical therapies for obesity in adults. Lancet. 2023;401(10382):1116-1130.
- Boer GA, Hay DL, Tups A. Obesity pharmacotherapy: incretin action in the central nervous system. Trends Pharmacol Sci. 2023;44(1):50-63.
- Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis. 2022;18:1345-1356.
- Rinella ME, Lazarus JV, Ratzui V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023;78(6):1966-1986.
See course for supplemental reading.
Assignments
- Week 15 Assignment: Key Assessment – Case Study Manuscript
Discussions
- Week 15 Discussion: Case Study Grand Round Presentation and Peer Review
Week 16: Future of Nutrition Therapy and Reflective Practice
Learning Outcomes
Students will be able to:
- Examine emerging trends and research related to nutrition assessment and nutrition therapy in one’s area of practice.
- Theorize areas of growth and opportunity in nutrition assessment and therapy.
- Reflect upon current and future opportunities for professional growth.
Lectures and Multimedia
- Reflective Practice
- Reflective Writing: It’s Personal, Professional, but not Perfect
Required Readings
- Commission on Dietetic Registration Scope and Standards of Practice Task Force. Practice is evolving – a briefing of the revised 2024 Scopes and Standards of Practice. J Acad Nutr Diet. 2024;124(2):279-283.
- Boak R, Palermo C, Beck EJ, et al. A qualitative exploration of the future of nutrition and dietetics in Australia and New Zealand: implications for the workforce. Nutr Diet. 2022;79(4):427-437.
See course for supplemental reading.
Assignments
- Week 16 Assignment: Course Reflection and E-Portfolio Piece
Discussions
- Week 16 Discussion: The Future of Nutrition Assessment and Therapy
Student Resources
Online Student Support
Your Student Support Specialist is a resource for you. Please don't hesitate to contact them for assistance, including, but not limited to course planning, current problems or issues in a course, resources to support academic success, technology concerns, or personal emergencies.
Questions? Visit the Student Support Applied Nutrition page
UNE Libraries
The University of New England Library Services are central to the intellectual life of the University community and an essential resource for doctorate students across didactic, residency, and research coursework and experiences.
UNE Library Services may be accessed through OKTA or by visiting https://library.une.edu/.
- Library Access for all students: Your library login ID and password are the same as the ones you use to log into Brightspace.
- Nutrition Resources
- Library Questions: Ask a librarian or phone library staff at (207) 602-2361 or (207) 221-4330.
Accommodations
Any student who would like to request, or ask any questions regarding, academic adjustments or accommodations must contact the Student Access Center at (207) 221-4438 or pcstudentaccess@une.edu. Student Access Center staff will evaluate the student's documentation and determine eligibility of accommodation(s) through the Student Access Center registration procedure.
Online Peer Support
Togetherall is a 24/7 communication and emotional support platform monitored by trained clinicians. It’s a safe place online to get things off your chest, have conversations, express yourself creatively, and learn how to manage your mental health. If sharing isn’t your thing, Togetherall has other tools and courses to help you look after yourself with plenty of resources to explore. Whether you’re struggling to cope, feeling low, or just need a place to talk, Togetherall can help you explore your feelings in a safe supportive environment. You can join Togetherall using your UNE email address.
Information Technology Services (ITS)
Students should notify their Student Support Specialist and instructor in the event of a problem relating to a course. This notification should occur promptly and proactively to support timely resolution.
ITS Contact: Toll-Free Help Desk 24 hours/7 days per week at 1-877-518-4673.
Career Ready Program
The College of Professional Studies supports its online students and alumni in their career journey!
The Career Ready Program provides tools and resources to help students explore and hone in on their career goals, search for jobs, create and improve professional documents, build professional network, learn interview skills, grow as a professional, and more. Come back often, at any time, as you move through your journey from career readiness as a student to career growth, satisfaction, and success as alumni.
Policies
AMA Writing Style Statement
In keeping with the requirements of the Journal of the Academy of Nutrition and Dietetics and the Journal of Nutrition Education and Behavior, the American Medical Association (AMA) Manual of Style, 11th edition is the required writing format for this course and is available at both UNE libraries under the title "AMA Manual." Additional support for academic writing and AMA format is provided throughout the coursework as well as at the UNE Portal for Online Students.
Online resources: AMA Style Guide
Turnitin Originality Check and Plagiarism Detection Tool
The College of Professional Studies uses Turnitin to help deter plagiarism and to foster the proper attribution of sources. Turnitin provides comparative reports for submitted assignments that reflect similarities in other written works. This can include, but is not limited to, previously submitted assignments, internet articles, research journals, and academic databases.
You can learn more about Turnitin here: Understanding the Similarity Score for Students.
Submission of Coursework for Publication or Presentation
Students interested in submitting a manuscript or other work completed in the course for publication or presentation external to UNE must obtain written approval from the course instructor and DCN Program Director prior to submission. The student should contact the course instructor or DCN Program Director to obtain a copy of the DCN Permission to Publish/Present Form which must be completed by the student per the form's instructions. Failure to follow these steps and complete the form prior to submission for publication/presentation or abide by the requirements therein will result in a professionalism violation. If granted permission to publish or present, the student is expected to indicate that the manuscript or other work was prepared as part of course and degree requirements while a student in the Doctor of Clinical Nutrition at the University of New England. University affiliation for publications, abstracts, posters, or other presentations should be listed as "Graduate Programs in Applied Nutrition, College of Professional Studies, University of New England." Please contact the DCN Program Director for UNE templates and logos that must be used for posters and presentations.
Technology Requirements
Please review the technical requirements for UNE Online Graduate Programs: Technical Requirements
Students are responsible for ensuring continuous access to computer and technology requirements throughout their program of study. Course faculty will not routinely accept computer or other technology issues as an excuse for assignments that are not submitted per instructions, that are submitted late, or are missing a submission.
Course Participation Policy
Courses within the DCN Program are demanding and exacting. Students are expected to be present in course discussions and group activities, prepared for class, and actively engaged as evidenced by critical thinking and meaningful participation. Students are expected to schedule their personal and/or professional obligations and their course registrations so as to maintain continuous and complete participation throughout courses. Any absence from course activities will impede learning. However, circumstances may arise that cause students to be absent from active course participation on either a preplanned or an emergency basis.
Active course participation is defined as engaged participation in group activities, fulfilling discussion requirements within the published timeline, and submitting assignments within the published timeline. Absence is defined as lacking engaged participation in group activities and not fulfilling discussion requirements within the published timeline, and/or not submitting assignments within the published timeline.
Both preplanned and emergency absences are to be kept to a minimum and should not exceed, cumulatively, 10% of the assignments in a course. Exceeding this limit may result in grade reduction for the course or failing the course. Students are to make arrangements in advance of the absences with the instructor for submission of assignments and discussion participation, in accordance with specifications communicated in the course syllabus. An emergency absence is one that students do not know about in advance and often involves situations such as health issues. In this case, students are to notify the instructor as soon as possible and make arrangements for submission of assignments and discussion participation in accordance with specifications communicated in the course syllabus.
Late Policy
Assignments: Assignments submitted after the due date and time will receive a deduction of 10% of the total possible grade for each day it is late. After three days, the assignment will not be accepted. No assignments will be accepted after the course ends.
Discussion posts: If the initial post is submitted late, acceptance of the discussion board is at the discretion of the faculty. Any posts submitted after the end of the Discussion Board week will not be graded.
Students are encouraged to make every effort ahead of time to contact their instructor and their student support specialist if they are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.
Attendance Policy
8 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Sunday at 11:59 pm ET of the first week of the term. Reinstatement is at the purview of the Dean's Office.
16 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Friday at 11:59 pm ET of the second week of the term. Reinstatement is at the purview of the Dean's Office.
Student Handbook Online - Policies and Procedures
The policies contained within this document apply to all students in the College of Professional Studies. It is each student's responsibility to know the contents of this handbook.
UNE Online Student Handbook
UNE Course Withdrawal
Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.
Academic Integrity
The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit UNE Plagiarism Policies.
Academic dishonesty includes, but is not limited to the following:
- Cheating, copying, or the offering or receiving of unauthorized assistance or information.
- Fabrication or falsification of data, results, or sources for papers or reports.
- Action which destroys or alters the work of another student.
- Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
- Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.
Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations. Appeal of a decision may be made to the Dean whose decision will be final. Student appeals will take place through the grievance process outlined in the student handbook.